On EHRs

Own your health

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That’s exactly what I did the past 6 months. And this week I graduated. From physical therapy that is. I’ve been cut loose. The next few months is all about me maintaining a daily discipline of stretches and canstockphoto15299929 (1) healthstrengthening exercises.

I first shared this journey in the post “Is there an app for that?” back in June. I also talked then about the importance of patient engagement and personalization.

I’m now around a 2-3 on the pain scale and closer to 2 most of the time. My physical therapist said if in a few months, I’m slipping back or feeling more pain I should get another prescription for more PT sessions from my PCP.

The stretches are much easier to make time for every day. There is short term gain plus a tangible benefit – I actually feel less pain. The strengthening exercises are harder to fit in, especially when I get busy or am travelling. With strengthening, there is no short term gain or tangible benefit – it’s all about the long term. Like going to the gym and doing weights.

The recent Fall ritual of raking leaves, bagging them, then carrying them to the curb led to a lot of pain. When I took care of my 2 ½ year old grandson and his 4-year-old sister recently for almost three days, all the lifting involved set me back. And I know the inevitable snow shoveling that is coming this winter will do so as well. My lower back muscles hurt just from all the coughing I’ve done the past 3 weeks with a bad chest cold.

My physical therapist says be sure to engage my core muscles at all these times and it won’t be so bad. I’m sure she’s right. I will try.

I am well armed with knowledge. I know what I need to do and how to do it. Will I slip backwards or continue to own it? Having lived with this low back and hip pain for years until it got so bad that I finally decided to get help, I know how bad it can be.

It’s now up to me. I need to continue to own it. As with any habit or exercise program, time will tell. Maybe an exercise tracking app or just an old-fashioned paper log is what I need.

Related Post:

Is there an app for that?

Apps aren’t enough

If not now, when?

Advancing healthcare through technology

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Healthcare is personal. Each of us knows stories of friends and family dealing with difficult medical issues. We hear how hard it can be to navigate the health system. It seems that one fills out the same information over canstockphoto21508588 (1) advancingand over and wonders why the physicians and hospitals don’t have it already. We hear how people must research their own conditions to make tough decisions about treatment options. We know there are access and affordability issues for many people.

As National Health IT week comes to an end, we must renew our commitment to make a positive impact on health care through technology.

I am fortunate to have worked with many passionate, committed people in healthcare over the past 30+ years. And I’m grateful to have a team of advisors working with us at StarBridge Advisors. Each has made an amazing and lasting impact on healthcare.

In our most recent StarBridge Advisors blog, “NHIT Week: 6 Leaders on the Value of HIT”, we discussed the value of health IT with six of our advisors. Their perspectives provide a lens into how technology is transforming healthcare though there is much more to do.

I encourage you to check out the perspectives shared by these CIOs and clinical leaders here. And if you like what you see, read more of our “View from the Bridge” posts and subscribe to receive notifications of new posts from our team of industry leaders.

Together, we all make a difference!

Related Posts:

Interoperability – Make it so.

HIEs matter

Our collective interoperability journey

The other end of the highway

Merger mania – is it good for the patient?

Aspiring to Stage 7

HIMSS Stage 7: what does it take?

Technology making a difference at scale

Predictions for 2018 – Our Future is Bright

A passion for healthcare

7 HIT blog and podcast recommendations

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I started blogging in 2014. It was a way to share experiences from many years as a health IT leader and to teach others. When I see the number of subscribers to my blog and 100,000 views to date, I think it’scanstockphoto58340963 (1) subscribe fair to say my blogs are having an impact. As long as that’s the case, I will keep blogging.

I was honored to see my blog named for the second year in a row to HealthTech’s Must-Read Health IT Blogger List. Here are some of the ones on that list that I plan to start reading more regularly:

Susannah Fox – She is the former CTO of HHS and covers a range of topics to help people and organizations navigate at the intersection of health and technology.

Inside the Mind of a Healthcare CIO by David Chou, Vice President / Chief Information & Digital Officer for Children’s Mercy Kansas City – I knew David was prolific on social media. I regularly read and share his content. But I didn’t realize that he was also writing a regular blog on a range of topics from his CIO experiences.

Health IT Buzz from ONC – This is a great way to keep up with what is coming from The Office of the National Coordinator and their perspective.

Health Populi by Jane Sarasohn-Kahn – I have met Jane at a few conferences in recent years and always find her insight and analysis to be very enlightening. She covers broad trends in healthcare. Something every IT leader should be tracking.

AAMI Blog – I may be biased as an AAMI board member, but I think all IT leaders need to be keeping tabs on what the issues are in the health technology management (HTM) world. Continue reading →

Is there an app for that?

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Have you ever experienced chronic pain? Did you try to ignore it and push through it? Or did you see your doctor and hope for a resolution?canstockphoto12572942 (002) joints

We expect quick fixes when something goes wrong. Yet chronic pain may mean physical therapy and daily exercises to strengthen certain muscles and address the cause of the pain. Far from a quick fix!

That’s what I’m going through now and at times my patience and discipline are low.  I’m supposed to do a series of focused exercises twice a day. I am trying to take the long view. Just like my shoulder surgery for a torn rotator when I had to do physical therapy for 6 months.

If I think I don’t have time for the exercises or I just don’t want to do them, I tell myself this is what it will take to relieve the back and hip pain I have been living with. No one is just going to fix it for me. Yes, my physical therapist will assess my pain level each visit, ask me how the newest exercises are working out, and determine what to add to my routine. But it’s on me between visits.

I’ve had four visits and try to schedule one once or twice a week. I know the time will come when the time between visits gets longer. And then she will tell me I’m on my own. It will be the true test of whether I own this or not. Will I make the time to do the exercises twice a day? Will I feel my slow progress and realize it’s working?

It’s like flossing your teeth, you need to own it. You can’t just do it for a few days before your teeth cleaning appointment – you have to make it a daily discipline.

I asked my physical therapist about studies on patients not doing their exercises at home. I told her about my experience of owning it after shoulder surgery. She asked me if I was owning this. I said I was getting there – trying to have the long view because I don’t want to live with pain. We need to own our own health. I can’t complain about the pain if I’m not willing to do my part.

We had a good chat. She described how her role is to help patients be successful. She has learned to not give too many exercises, or the patient won’t do them. If the patient hates the exercise, she knows they won’t do it. She has to find an acceptable alternative. And she emphasizes patient education. Continue reading →

The other end of the highway

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This morning I was looking out my window at a new 3 inches snowfall while making conference calls. Tonight, I’m driving past palm trees. This afternoon I was on I-95 driving to the Providence airport for a canstockphoto25609566 (002) highwayflight to see a new client. Tonight, I’m exiting a Florida airport in a rental car and merging onto I-95 heading south.

With google maps piped through the car rental audio, I am confident I will get to the hotel 50 minutes away. I have done all the initial lane changes and merging, so now I’ve got a 19 mile stretch before the next turn. It’s safe to call home on speed dial and chat with my husband. I do the ritual “woe is me” that my flight was delayed, the airport was busier than I expected, and there was a long wait for the car rental center shuttle. But I’m finally on the road to my hotel much later than expected and very hungry. I am aware that these all are first world problems.

We have the “I’m still on I-95 but with palm trees” conversation. When I exit I-95, it is crystal clear that I am 1,500 miles south of the I-95 I’m used to. The “lady” in the car audio is telling me to merge onto Dolphin Expressway. No road in Rhode Island is called Dolphin Expressway!

I dislike busy unfamiliar expressways, driving at night (especially with lane changes) and driving in the rain (in that order). Fortunately, this was only 2 of the 3 – it was dry, with no rain (or snow). In these situations, lane management is critical, and the navigator system can only help so much. And good signage is critical or as my daughter says, “use your eyes”.

What does this have to do with healthcare and IT? Continue reading →

Merger mania – is it good for the patient?

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In just the past few weeks, we saw several major healthcare merger announcements – Dignity and CHI, Advocate and Aurora, Ascension and Providence St. Joseph Health on the provider side. And then there’scanstockphoto18678854 CVS Health and Aetna – a potential disruptor in the healthcare market. And we don’t yet know what other market disruptors like Amazon or Google might do in the healthcare space.

There have been predictions in recent years that eventually there would be just 10-15 major healthcare systems in the U.S. Are we on our way to that prediction with the latest merger announcements?  The combined Advocate and Aurora system would create a 27-hospital healthcare system in Wisconsin and Illinois with projected annual revenue of $11 billion. The Dignity and CHI merger would include 139 hospitals in 28 states. If Ascension and Providence St. Joseph Health merge they would create the largest hospital chain with 191 hospitals in 27 states and annual revenue of $44.8 billion.

What is driving these mega mergers? The announcements about them talk about improved access to care, improved outcomes, lower costs, sharing best practices and overall being more prepared for success in the changing healthcare market and landscape.

Jane Sarsohn-Kahn, health economist, wrote a great piece earlier this month – “Will Getting Bigger Make Hospitals Get Better?”.  She talked about the value that matters to patients — the trust that is needed between hospitals and patients.

And what are the IT implications of these mergers? If markets don’t really overlap, what degree of system integration is needed? Is one seamless patient record needed as it is for large regional systems with a lot of patient movement between community hospitals and specialists at academic medical centers? Continue reading →

HIMSS Stage 7: what does it take?

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This week, I participated in another HIMSS Analytics Acute Care EMRAM Stage 7 review team as the CIO reviewer. During the opening presentations by the organization’s leadership, I leaned over to theHIMSS EMRAM 2018

full-time HIMSS reviewer to say, “They are hitting it out of the ballpark”. By the end of the day, our three-person review team had indeed reached that conclusion. The full-time reviewer said, “Some organizations barely clear the bar but this one far exceeded it.”

Only 6.1% of hospitals have achieved Stage 7.  What does it take?

On review day, the review team is presented with information that includes a system overview, including governance, clinical and business intelligence, health information exchange, and plans for disaster recovery and business continuity.

The review team has been given a 17-page document that includes checklists for each major clinical area.

Several case studies are presented that demonstrate how the organization has used the system to improve clinical care.

The organization prepares for this visit for months, developing the case studies and verifying they have met every specific criterion. The full-time reviewer spends time on the phone reviewing their readiness.

Achieving Stage 7 takes teamwork throughout the organization to fully leverage all aspects of the vendor’s product. It takes engagement and passion from executives and clinicians.

The organization we were reviewing implemented their EMR according to these guiding principles: Continue reading →

HIEs matter

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We have watched with sadness as Hurricane Harvey has flooded first southeast Texas and now Louisiana. We have seen the spirit of the American people at its best. Volunteers from around the countrycanstockphoto30688369 have brought their own boats to rescue residents while thousands have donated money and supplies. As of Thursday morning, there had been over 25,000 water rescues.

Hospitals are meant to operate and care for patients 24/7 through a disaster. But they too were impacted by the rising waters. I took a break mid-day yesterday to watch the news. I saw in that 15-minutes the evacuation of patients from Baptist Hospital in Beaumont, Texas after the city lost its water supply. Without clean water, the hospital had to close and transfer 190 patients.

Patients, many in wheelchairs, needing dialysis treatment were being boarded onto Black Hawk helicopters by teams of doctors and nurses. They were being handed over to military medics to be flown to a hospital in Jasper, Texas – 70 miles away.

The last step in the transfer process was a clinician giving a folded-up paper to the medic. She had stuffed it under her shirt until that point so it didn’t blow away in the wind from the helicopter propellers. We know that this critical paper handoff probably happened over and over this week as patients were transferred to other facilities.

In this age of electronic medical records (EMRs) and health information exchanges (HIEs), we hope that piece of paper is a backup document. Transfers within a health system with a common EMR should be able to rely on the system for access to critical patient information. Health systems that participate in HIEs should be able to rely on some level of data exchange and access between health systems and their disparate EMRs.

I was encouraged to see two health IT articles this week – “As Harvey Devastates Houston, HIE Leaders Move in to Help” in Healthcare Informatics, and “What’s Next for Health Information Exchanges?” in Healthcare IT News. The first article describes the power of the HIE in Texas; portals have been set up in the many shelters so clinicians can access critical health information as they care for people in need of medical attention. The second article talks about the future needs that HIEs could meet and their potential benefits as healthcare continues to evolve. Continue reading →

HTM and IT: frenemies or collaborators?

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What is a “frenemy”? According to Dictionary.com: “person or group that is friendly toward another because the relationship brings benefits, but harbors feelings of resentment or rivalry”.canstockphoto5722510

Within health care organizations, there is a lot of history between the people who support the medical devices that touch patients and those who support the information systems used by clinicians. It has not always been positive and collaborative. In fact, there are such differences in the culture of each group that they don’t always get along. Maybe they are even “frenemies” in some organizations.

In your hospital, you may know the function as Biomedical Engineering, Biomed, Clinical Engineering or Health Technology Management (HTM) as it is now called as part of elevating the profession within healthcare. Those in the field now refer to themselves as “HTMs”.

AAMI (Association for the Advancement of Medical Instrumentation) is a standards development organization and the professional society for HTMs. AAMI is celebrating its 50th anniversary this year. Its mission is to advance safety in healthcare technology.

Four years ago, I was the first CIO ever to be elected to the AAMI board when AAMI leaders recognized the trend towards HTM and IT convergence and integration. I have provided the IT perspective to the AAMI board as the HTM profession continues to evolve. Continue reading →

Aspiring to Stage 7

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I recently participated as the CIO reviewer on a HIMSS Analytics Stage 7 validation. The long travel to the West Coast aside, I was happy to contribute my time and expertise to be exposed to an advanced

Source: HIMSS Analytics

Source: HIMSS Analytics

organization and to meet a wonderful group of leaders. The review team also included a Chief Medical Information Officer and the HIMSS Analytics Regional Director for North America.

As of the 3rd quarter this year, only 4.6% of hospitals have achieved Stage 7 while 30.5% have achieved Stage 6. Just over a third of hospitals are currently at Stage 5.

All three hospitals I’ve served as CIO have achieved Stage 6. Getting from Stage 6 to 7 is a significant leap. There is a greater focus on analytics and using the data from the electronic health record to improve patient outcomes.

From the HIMSS Analytics website, here is how Stage 7 is described: Continue reading →